Preparing for the Donald Trump Administration: Key Questions for Providers

Ken Kaufman of Kaufman Hall in Chicago, does a nice job of suggesting healthcare changes in the Trump Administration. The full article can be found at www.kaufmanhall.com.

Preparing for the Donald Trump Administration: Key Questions for Providers

The election of Donald Trump as U.S. President introduces a new degree of uncertainty for healthcare providers. At this early stage, it is not possible to say exactly when or how U.S. health policy might change, or how those changes might affect provider organizations. However, it is possible to identify the key issues to monitor and ways in which provider executives can assess the possible effects of different scenarios.

How Likely Are Significant Changes to the Affordable Care Act?

During his presidential campaign, Donald Trump expressed a goal of repealing and replacing the 2010 Affordable Care Act (ACA). As the President-Elect prepares to take office, one key question for providers is whether an ACA repeal is feasible and how quickly changes to the law might occur.

Analysts have pointed out that multiple barriers exist to repealing and replacing the law in the short term. Outright repeal would likely face a Democratic filibuster in the Senate, and it could take more than a year to develop and implement a replacement law and accompanying regulations. However, analysts also point out that other options exist to change the law. These include using the budget reconciliation process to change how the current law is funded and creating new regulations that change how the law is implemented.

For more detailed insight into the potential for ACA changes, see the Health Affairs Blog article “Day One And Beyond: What Trump’s Election Means For The ACA” by respected health law scholar and ACA expert Timothy Jost, J.D., Emeritus Professor at the Washington and Lee University School of Law.

How Might Health Policy Change in the Trump Administration?

The logical next question is what health policy might look like under the Trump Administration. In the absence of legislative or regulatory activity, it is impossible to answer this question with certainty. However, the goals that President-Elect Trump outlined during the campaign provide a place to begin. Those goals include:

Allowing the sale of health insurance across state lines with the intent that increased competition would lower insurance costs

Making health insurance premiums tax deductible for individuals

Promoting the use of health savings accounts

Requiring price transparency from all healthcare providers to help consumers comparison shop

Providing block grants to states for their Medicaid programs

Removing barriers to the sale of imported medications

To date, President-Elect Trump has not addressed the aspects of the ACA that promote value-based payment, and he recently expressed support for provisions requiring coverage of individuals with pre-existing conditions and allowing dependents to remain on their parents’ health insurance policies until age 26.

What Other Changes Might Affect Healthcare in a Trump Administration?

To the extent that the Trump Administration and a Republican-controlled Congress focus on reforming entitlement programs, healthcare spending would get close attention. Medicare, Medicaid, the Children’s Health Insurance Program, and ACA exchange subsidiaries constitute the largest segment of Federal spending—25 percent, compared with 24 percent for Social Security and 16 percent for defense. Any actions to reduce healthcare spending could create additional revenue pressure on providers, including the possibility of spending cuts.